Abstract The overarching goal for The University of Kansas Cancer Center ? Midwest Cancer Alliance Rural NCORP (KUCC-MCA Rural NCORP) is to enhance capacity for increasing clinical trials accrual and participation of rural populations in cancer control, prevention, treatment, and care delivery clinical trials, as well as in other human research developed and conducted by NCORP Research Bases. While cancer affects all population groups, certain subgroups, including those living in rural communities, are more at risk than others.[1, 2] Contributing risk factors include older age, inadequate insurance coverage, lower socio-economic status, minority race, and more isolated geography?all of which can be barriers to receiving specialty healthcare. Inaccessibility of clinical trials due to geographical barriers clearly disadvantages rural patients and is their most frequently cited reason for not enrolling in studies.[5] Patients living in suburban areas have the highest accrual rates to clinical trials, while those by patients living in rural areas is quite low[6, 7]. The University of Kansas Cancer Center (KUCC) is strongly positioned to enhance clinical trial accrual and participation of rural populations through its leadership of the Midwest Cancer Alliance (MCA) and its cadre of accomplished investigators with extensive experience working with rural communities and practices. As the outreach network of the KUCC, the MCA has partnered with hospitals, cancer centers, and health care providers across the state of Kansas for over a decade. The goal of these MCA partnerships has always been to extend the reach of clinical research into under-represented communities, with a focus on rural and low-income communities. MCA recently expanded to include our state-wide rural primary care practice based research network, Kansas Patients and Providers Engaged in Prevention Research (KPPEPR), a network of over 75 primary care providers from across Kansas with a longstanding history of supporting cancer prevention and control research initiatives. KUCC-MCA Rural NCORP will leverage our over 45-year experience as a SWOG-member, 20-year experience providing oncology care via telemedicine, 15-year history of successfully conducting research in rural primary care settings, and 10-year experience opening and running clinical trials within rural health care networks?all supported by KUCC expertise in partnering with rural oncology and primary care practices to accomplish our goals. Specifically for the KUCC-MCA Rural NCORP, we will assess institutional, provider, clinical trial, and patient barriers to trial accrual, and implement processes to: 1) Enhance the infrastructure of local cancer centers and primary care offices to support clinical trials accrual in rural communities; 2) Expand access to clinical trials across the MCA network by offering available NCORP clinical trials in local rural communities; 3) Decrease barriers to clinical trial participation for rural and low-income patients across Kansas and western Missouri by providing trial participation opportunities in their home communities; and 4) Leverage KUCC/MCA expertise for addressing rural cancer disparities to clinical trial participation with NCORP grantees.